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Orlynvah - Sulopenem Etzadroxil And Probenecid tablet, Film Coated
Regence BlueCross BlueShield
Regence BlueCross BlueShield Coverage for Orlynvah - Sulopenem Etzadroxil And Probenecid tablet, Film Coated
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5
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2
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1
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2
Commercial
Commercial - PPO
PA Required
No Step Therapy
Quantity Limit
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Commercial - Employer
PA Required
No Step Therapy
Quantity Limit
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Health Exchange
Health Exchange - PPO - Health Insurance Exchange
No PA
No Step Therapy
No Quantity Limit
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Medicare
Medicare - Medicare Advantage Part D
No PA
No Step Therapy
No Quantity Limit
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Medicare - Prescription Drug Plan
No PA
No Step Therapy
No Quantity Limit
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